I don’t know how to handle this Nursing question and need guidance.

NSG 350 MENTAL HEALTH – THERAPEUTIC RELATIONSHIPS CASE STUDY

Please Provide Answers with Rationales

Emma is not having an easy time with her new client, Mrs. Rhodes, a young mother of three who is being hospitalized for depression. Her husband travels a great deal, and she feels isolated and overwhelmed by some of her children’s behaviors and other parenting challenges. She has become increasingly withdrawn and tearful.

Emma and her patient, Mrs. Rhodes, are scheduled to meet twice a day for one-on-one sessions. In their first session, Emma identifies roles and parameters, establishes their informal contract for these meetings, and set mutual goals. She also encourages Mrs. Rhodes to take the lead in stating her goals. Things seem to go all right, although Mrs. Rhodes is, of course, very depressed.

However, the second session becomes much more challenging because, as Emma asks questions to establish rapport, and as Mrs. Rhodes begins to share some of her feelings, she starts to cry as she describes an argument with her sister. When the patient suddenly says, “I feel so alone, so lonely. That’s the real problem. What I need is a real friend, not a nurse. I like you. Can we just be friends?”

When Emma tries to explain that this is not the function of the nurse–patient relationship, Mrs. Rhodes smiles awkwardly and says, “I understand.”

They talk a little more, and Emma thinks that things are going well, but suddenly Mrs. Rhodes stands and says, “I’m sorry. I can’t do this. I’m going back to my room.”

1. Emma feels rejected by Mrs. Rhodes. “I thought we liked each other,” she tells you. “What did I do wrong? It is true that I had to explain the boundaries of the nurse-patient relationship, but she seemed to understand and handle it well. Does she hate me now?” Assuming that Mrs. Rhodes did understand, and assuming that Emma did nothing that particularly offended her, what might be the cause of Mrs. Rhodes’ suddenly leaving?

2. Emma pursues Mrs. Rhodes just into the hallway. When Mrs. Rhodes whispers, “Please, I just need to be alone,” Emma doesn’t know what to do. Should she let her go or insist she return? And if she does let her go, what should she do next?

Additional Questions

• What should you do if a patient who can’t cope with the loss of his job and potential loss of his family’s home confides that he is thinking of committing suicide?
• How should you handle it if a recently widowed patient makes a sexual advance toward you?
• What is the appropriate response to a patient who has an eating disorder and starts crying during a session?
• What if an adolescent patient who has been bullied at her new school refuses to talk to you?